经支气管针吸活检术在纵隔及肺部疾病诊断中的应用价值  

Application value of transbronchial needle aspiration in the diagnosis of patients with mediastinal and pulmonary disease

作　　者：邓翔[1] 王焕勤[1] 刘帅[1] 买佳[1] 王圆方[1] 周璐[1] 王静[1] 

机构地区：[1]郑州大学第一附属医院呼吸与危重症医学科,河南郑州450052

出　　处：《河南医学研究》2015年第4期17-19,共3页Henan Medical Research

基　　金：河南省科技攻关项目(112102310102)

摘　　要：目的探讨经支气管针吸活检术(transbronchial needle aspiration,TBNA)在纵隔及肺部疾病诊断中的价值。方法对68例CT提示肺占位或单纯纵隔淋巴结肿大患者行TBNA检查,再以毛刷在穿刺点处刷检,如果可见局部黏膜增厚或充血水肿需另行活检,取得的标本送病理学检查。比较TBNA与活检、刷检组的诊断阳性率,评价TBNA的有效性及安全性,分析其影响因素。结果 68例患者中阳性56例,诊断阳性率为82.4%,高于常规检查组(51.5%)(P<0.05)。隆突下淋巴结组阳性率高于非隆突下淋巴结(96.0%比63.2%)(P<0.05),淋巴结直径≥2 cm组阳性率高于淋巴结直径<2 cm组(92.6%比60.7%)(P<0.05)。22例少量出血,无其他并发症。结论 TBNA对纵隔及肺部疾病的诊断有较大的临床应用价值。Objective To explore the application value of transbronchial needle aspiration（TBNA）in the diagnosis of medi-astinal and the pulmonary disease.Methods 68 patients with lung space -occupying lesions or mediastinal lymphadenopathy diagnosed by CT were checked by TBNA and subsequent brush cytology at the TBNA site.Addtional biopsy were carried out when thickened local mucosa,congestion or edema were found,and the specimens were sent for pathology examination.The diag-nostic rate of TBNA and routine methods were compared to evaluate the validity and safty of TBNA.The possible influcening fac-tors were analyzed.Results 56 patients of 68 patients were diagnosed by TBNA,the positive diagnostic rate was 82.4%,high-er than routine methods with 51.5%（P 〈0.05）.The positive rate of subcarinal lymph node group was higher than non -subcar-inal lymph node （96.0% vs 63.2%）（P 〈0.05）.Lymph node larger than 2 cm in diameter group had a higher positive rate than those lymph node less than 2 cm（92.6% vs 60.7%）（P 〈0.05）.22 patients had little bleeding,and no other complica-tion was observed.Conclusion TBNA had a great clinical application value in the diagnosis of mediastinal and pulmonary dis-ease with high security.

关 键 词：经支气管针吸活检术 纵隔淋巴结肿大 肺占位 

分 类 号：R56[医药卫生—呼吸系统]